MedicareComplete - Choosing a PCP

1. 1 MedicareComplete - Choosing a PCP Members in coordinated care plans (HMO,POS,PPO) must select a Primary Care Physician (PCP) at time of enrollment.* This ensures consumer has reviewed plan network, and has a network physician to access if services are needed. PCPs are an important part of health management. By choosing a PCP, a member has a doctor who is familiar with his/her medical history and can appropriately coordinate the member�s care.

2. 2 MedicareComplete - Choosing a PCP(continued) Care Coordination For �gatekeeper� plans (those that have referral requirements), PCP coordinates care with specialists/hospitals For �open access� or �specialist self referral� plans, selected PCP is an option, but member may at any time seek care from a different network primary care physician or specialist without a referral Not all plans require members to obtain referrals from their PCP. For �open access� or �specialist self referral� plans, no referrals are required for specialist or other network services. Referral requirements are detailed in the Summary of Benefits, #2, Doctor and Hospital Choice. Oxford plans require members (or member�s network physician) to obtain prior authorization before obtaining certain covered services